Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD443589 | PA |
NPI | 1053579714 |
---|---|
Provider Name | Guillermo Ernesto Carnero Salazar |
First Address | Allentown, PA 18104 |
Second Address | Allentown, PA 18104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 02/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102772903 | (05) | PA |